Organization Active NPI

Raquel L Lopez DDS Family Dentistry P.C

  • General Practice Dentistry
  • Brentwood, NY
National Provider Identifier
1316102585
Registry record updated Jul 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049156 Issued in NY
Legal business name
RAQUEL L LOPEZ DDS FAMILY DENTISTRY P.C
Practice address
1247 Suffolk Ave
Suite #2
Brentwood, NY 11717-4518
Phone
(631) 434-7156
NPI assigned
Jul 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Raquel L Lopez, D.D.SNPI 1225494180
Title
Owner
Phone
(516) 380-1441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 049156 NY Primary

Addresses

Primary practice location

1247 Suffolk Ave
Suite #2
Brentwood, NY 11717-4518

Mailing address

47 Ciliotta LN
Port Jefferson Station, NY 11776-3435
Phone (516) 380-1441

National Provider Directory

National Provider Directory

Locations

1247 Suffolk Ave
Ste 2
Brentwood, NY 11717
Phone (631) 434-7156

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217030400000",
    "number": "1316102585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CILIOTTA LN",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763435",
            "telephone_number": "516-380-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 SUFFOLK AVE",
            "address_2": "SUITE #2",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174518",
            "telephone_number": "631-434-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAQUEL L LOPEZ DDS FAMILY DENTISTRY P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-26",
        "last_updated": "2008-07-26",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-380-1441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.